and here we are…
And here is a summary of thread 16 happenings:
1. Discussion about suppliers of masks and the prices we are paying for them (including a hello from Canada with a comparison there)
2. Nikolai is away for a few days (but he sneaked onto his friend’s computer and managed an entry)
3. Looking at Australia as a ‘melting pot’ of ethnic groups
4. Some discussion about the situation in Indonesia - mainly left to the key threads on this.
As to 4 above, to have 6 further cases confirmed (nothing to do with the cluster) and all in differing regions has me shaking my head.
Have a good day everyone
Thanks Annie :)
Anybody else see Tony Abbott’s announcement (as reported in Sydney Morning Herald) that “essential personnel” involved in dealing with a pandemic in Australia WON’T be getting anti-virals as a preventaive measure?
That should go over really well with all the people putting their lives at risk. The reason given in the article was it was “too difficult to decide who the essential personell were”.
This sounds like there has been woeful planning to date. I hope somebody wakes up pretty soon.
RobT: didnt see or hear that one! where was it reported?
Sorry everyone, forgot to include the url to the Tony Abbott article. For those who don’t know, Tony Abbott is Australia’s Federal (ie national) Health Minister.
Mr. Abbott has also stated in the past that the number of deaths expected in Australia from an H5N1 pandemic is 0.2% of the population. Yeah right.
][url=http://www.abc.net.au/news/newsitems/200605/s1651202.htm]Indonesia’s approach to bird flu concerns Abbott[/url][/b]
Last Update: Tuesday, May 30, 2006. 4:39pm (AEST)
The Federal Health Minister Tony Abbott says he is concerned about Indonesia’s efforts to manage and control the spread of bird flu.
There have been several recent bird flu deaths in Indonesia.
After releasing a revised plan to handle an influenza pandemic, Mr Abbott revealed his concern about Indonesia’s approach to bird flu.
“There is still not effective surveillance of poultry stocks, there could be improvements in reporting,” Mr Abbott said.
But Australia’s chief health officer John Horvath is playing down the concern.
He says if there was a pandemic outbreak, the nation’s proximity to Indonesia would not make much difference.
[b]”Where it breaks out it would be a worldwide event within 24 hours,” he said.[/b]
[u]Outbreak simulation[/u] A major exercise involving the simulation of an influenza pandemic will be held later this year.
Federal and state governments will take part in the four-day trial in Brisbane in October.
It will simulate the arrival of an international passenger infected with pandemic influenza.
Mr Abbott says the plan also considers how to handle overseas travellers.
“We would be requiring the captains of all incoming planes to make positive declarations as to the status of their passengers,” he said.
“Any plane that arrived with infected passengers would be placed in quarantine, what we wouldn’t be doing though is ordering the shutdown of all international transport.”
[u]Anti-virals[/v] The Federal Government has changed its plans for allocating anti-viral drugs in the event of an influenza pandemic.
The Government had previously planned to give stockpiled medicines to a wide range of essential service workers if there was an outbreak of influenza, such as a bird flu pandemic.
But a revised strategy released today proposes only giving the drugs to those infected, and health workers treating them.
Mr Abbott says the previous aim is not feasible.
“We came to the conclusion in consultation with the states that the attempt to keep prophylaxis going for the up to 1 million people who would normally be deemed essential was simply not going to work, there would never be enough anti-virals to do so,” he said
bump
Thanks AussieOne, good find. There is another piece today re-iterating that Abbott believes there may be 44,000 (0.22% of population) deaths in Australia. That’s up from 39,000 or 0.20%)
So that’s good, they’re getting to see that it may be more serious than previously imagined!!(LOL)
I just don’t get it with these guys. I’m starting to think there may be a deliberate misinformation campaign to minimise the threat. I see it as follows:
Australia’s population is currently about 20 million. The case
attack percentage is usually given as about 30%, ie 30% of the population is expected to “catch the flu”. The Indonesian H5N1 is killing 75% of those that get ill via multi system organ failure as well as ARDS. Let’s be as optimistic as possible and estimate that the virulence will drop down from 75% to say 25%. Therefore we should be planning on the impacts of 1.5 million deaths in Australia (20million X 30% attack rate X 25% case fatality rate) directly from flu infection, this does not account for collateral deaths from scarce medical services, lack of supply of heart medication etc etc.
It seems our “leaders” are planning on a 0.7% case fatality rate!( 20million X 30% = 6million, then divide into their expected fatality of 44,000) I’d really like to know on what basis they are coming up with such a low estimate. My real concern is that the planning they are doing is completely useless, and the consequent impact will be devastating, with lots of hand wringing after the pandemic passes and statements like “Gee, we didn’t know it was going to be so bad, you can’t blame us.”
There certainly seems to be little critical examination of this issue in Australia…it’s a bit of a worry.
bump
Wednesday, May 31, 2006 Australia’s best laid plans
Australia had a great pandemic flu plan. On paper. Now paper is confronting reality and reality is winning.
Like a number of other places, it seemed only common sense that the priority for Tamiflu would be essential workers. Back in October the Australian government said it had enough Tamiflu for 1,000,000:
The Federal Health Minister, Tony Abbott, has been very frank about the inadequacy of Australian stockpiles:
“Certainly, we don’t have anything like enough antivirals to protect the entire population. At present, we have enough antivirals to protect one million essential service workers for about six weeks.”
He has also been very candid about supply constraints being a clear reason for the limited stockpiles:
“[A]t the moment there are no additional antivirals anywhere in the world . . . If there were more antivirals to be had, by all means [we would expand stockpiles]. But on the best evidence we have, there aren’t.”
Providing such protection will be essential in order to ensure that workers such as police, doctors, nurses, water and electricity staff and airport employees turn up for work and maintain essential infrastructure. When supplies run out after 6 weeks or so, Australia will then be competing to obtain preferential treatment for a scarce resource from Roche. (Medical Journal of Australia) It turns out even this bit of pessimism was too optimistic. Australia has reversed direction and now will give Tamiflu only to the sick and those directly exposed to the sick:
“We came to the conclusion in consultation with the states that the attempt to keep prophylaxis going for the up to 1 million people who would normally be deemed essential was simply not going to work, there would never be enough anti-virals to do so,” he said. (Australian Broadcasting Corporation) Either a lot of Tamiflu disappeared since October, or the amount of Tamiflu was overestimated, or . . . they were just blowing smoke?
For what it is worth, my opinion is that the Australian Government was not “blowing smoke” and none of the reasons for the change as suggested are likely.
My guess is simply that an adequate course of Tamiflu is now greater than what was expected - thus 1 million tablets are not a sufficient amount to service the numbers required.
How do you choose who gets a full dose amongst essential personnel and those that dont…or wont get any.
I think Revere’s point is that the paper plan on how to deal with a pandemic can look great, but when it comes to implementing it, the holes in the plan become apparent. Clearly, the estimation of the requirement to cover frontline essential persons was inadequate from the beginning, but that didn’t stop media releases going out about how well advanced our planning was. Just more “feel good” stuff for the masses. Another example is Abbott’s latest statements on keeping the pandemic from comingto Australia. Airline captains will have to certify that no=one on board is ill. And how are they supposed to do that, exactly. Have they been trained in diagnosing flu? What if the passenger, or crew, are asymtomatic? How is that supposed to be picked up?
We’re being fed BS, and it is a disservice to the community because the cold hard facts are not being discussed. People will not prepare if they are led to believe “everything is OK”.
I think Revere’s point is that the paper plan on how to deal with a pandemic can look great, but when it comes to implementing it, the holes in the plan become apparent. Clearly, the estimation of the requirement to cover frontline essential persons was inadequate from the beginning, but that didn’t stop media releases going out about how well advanced our planning was. Just more “feel good” stuff for the masses. Another example is Abbott’s latest statements on keeping the pandemic from comingto Australia. Airline captains will have to certify that no=one on board is ill. And how are they supposed to do that, exactly. Have they been trained in diagnosing flu? What if the passenger, or crew, are asymtomatic? How is that supposed to be picked up?
We’re being fed BS, and it is a disservice to the community because the cold hard facts are not being discussed. People will not prepare if they are led to believe “everything is OK”.
Bump
I think Abbott is just demonstrating common sense. There is not enough Tamiflu to go around and I can see endless wheedling, fighting, strikes, blackmail and so on about who is “essential”. Abbott has stopped all that in its tracks.
but does that mean our water food etc is now at risk if essential services are not given vaccine? anyone see the Syd Morn Herald article today re BF will try to link it later played it down i thought.
would Dr’s and Nurses be considered “carers” does anyone know? Dont like the chances of them turning up to work if they know they’ll be exposed..
Did anyone notice the “Panic in the Streets” movie special its about bubonic plague (now here is one for all fluwikians) anyway.. Wed 7 June 7pm general lecture theatre Uni of syd it has been put on by Aust Society for Medical Research. You watch the ‘film noir’ classic then! AN EXPERT panel (epidemiologists etc) discussing Could it happen now ie killer pandemic.It is free but you must book 93852582. All wikians please wear your pink carnations! It was advertised in the Syd Morn Herald - Nikolai this sounds like a must!
bump
Thanks Anonomous. It sounds very good. They have 2 very good people on the discussion panel in an epidemiologist and virologist, so should be a great chance to explore the issues with professionals in the field. See you there. Anybody else from fluwikie coming?
Me hopefully :)
I will be there with other wikians - we will be the ones asking all the questions!
bump
Where are you Nikolai-Sydney? I miss your “free verse” postings that were slightly more method than madness. Just kidding. I like your riffs.
Same sort of stuff here in the US. they must think that they are fooling some people or they wouldn’t keep it up. Nothing unusual about that. SSDD. Last night I was reading an official meeting transcript from a Colorado State Emergency Management meeting that was held recently. In the transcripts one of the participants said that they would not be posting the State Pandemic Plan online because “people would see the holes in it”. ha ha!!! that about sums it up from here. Good luck to you down there!
now that we have the news from indonesia…i wonder how many of us down here will be prepping. Indonesia is soooo bloody close to us
Hi this is Chris from Auckland NZ
I’m hoping that something of the NYT article makes it to the mainstream media here, I think that’s the only way that it’ll have an impact on prepping down here.
One of my friends is also prepping, but we are having a ridiculously hard time convincing another mutual friend to do anything. He’s far more concerned about repayments on his new mortgage than spending $10 on 10 kg of rice even.
NZ media gives almost no news on these events -it’s like they have been gaged-and the gov’t dribbles on about being one of the most prepared- ha ha Their stockpile at twice the dose for twice the time will cover less than 5% of population and they haven’t ordered relenza - which is a great decision considering it may be the only drug with a decent resistence profile once this thing starts to bounce.
Yes but in nz dr k havent they distributed pamphlets about prepping to citizens etc I thought their info campaign was quite extensive?
Re Niman’s posting about the phasing out of stage 4 and 5 (WHO) this has major consequences for the Aust Pandemic Plan which basically follows the WHO phasing.
For example what is our Govt doing now re their planning if they are following WHO and WHO is changing the gameplan? Surely we have to be worried about that because our Govt does have lots of plans in place but most of this roll out Stage 4 and Stage 5 - but if WHO doesnt move to this level does that mean our govt wont roll them out?? the implications of are mind blowing.
Feel like you are the only australian preparing? visit http://www.aussurvivalist.com/forum/forum_topics.asp?FID=2 over 8000 views to their site about How to get started prepping for BF perhaps tinned tuna will disappear soon!
Hello, RobT,
Could you clarify if the Aust. health minister is saying that essential workers in PH won’t get PREexposure prophylaxis, POSTexposure prophylaxis, or both? Preexposure prophy would consume an enormous amt of meds, likely leaving a shortage for those who really need it; it has been pretty universally condemned as not a good idea. POSTexp. prophy, however, would be a good idea, since is time is of the essence in starting meds after you get exposed. Kind of like starting AZT after an HIV+ needlestick. That said, if supplies are truly low, then it would make the most sense to only use the drugs therapeutically (not prophylactically) as soon as possible after to onset of symptoms.
The other consideration here is that the current dosage/duration recommendations for Tamiflu are likely far too low for H5N1. The recent ferret study that showed remarkable results with Tam. (100% dead without it; 100% survival with it) used about 15 - 30 mg/kg. On the other hand, for a 150 lb person, the therapeutic dose is 2 mg/kg and prophy dose is 1 mg/kg. Probably enough to make the virus mad and mutate, but not enough to kill it. So I foresee that the dosing recommendation will eventually go up to 300 mg/day for 10 days. Meaning that the stockpile you thought you had to 10,000 would suddenly become a stockpile for 2,500. This should influence how liberally it’s planned to be used for prophy, rather than treatment.
On the positive side, Clade 2 (the version of H5N1 near you guys in Indonesia) is sensitive to the old, cheap and plentiful adamantanes (amantadine and rimantidine). This clade is the one that had spread to Europe and Africa, so if the pandemic strain comes from this and it remains sensitive to these drugs, the anxiety about the Tamiflu/Relenza rationing would be relieved. In fact, it had been proposed that NI’s and adamantanes be used together for treatment, which would make supreme sense, since they work on different parts of the virus’ reproductive cycle. Could be a VERY effective treatment.
If anyone reading this has any research pull Down Under, clinical trials with higher doses of NI’s and with combination therapy are urgently needed. I hope that they are going on, but there’s been some very weird persistent gaps in our knowledge, like population seroprevalence studies so we can assess the true case fatality rate. Very frustrating.
Best wishes to all of you.
Hi Epi thanks for the extremely useful comments - unfort I dont have the status to make it move to govt but perhaps other onlookers of the site here in Aus do thanks again
Hi, all!
Nothing very nice about my holiday. Previously, I thought it was troubling enough to get INDIFFERENCE from others about the threat we perceive from an influenza pandemic.
Believe me, that is nothing compared to systematic and well infomed HOSTILITY from a very intelligent ‘friend’ let me say.
Started with seeming innocence with AIDS. Sure, I think that’s terrible. How many dying? Thousands and thousands. Be specific. I don’t know, hundreds of thousands?
Told to try on THREE MILLION deaths in the last year. Told to consider EIGHT THOUSAND deaths A DAY…
Asked how many dying every day from H5N1. And so on, through asteroids, peak oil, global warming, war on terror, malaria, TB… I won’t go on, this is a dedicated site. But I do see that there are other concerns out there and intelligent, well informed people who are concerned about more than I am.
I shall maintain prepping, but no more criticism from me for those who are not acutely conscious of this as THE problem facing humankind todlay….
And no more holidays or discussions with so-called friends!
Nikolai!! Welcome back…we’ve missed you! Sorry your holiday was not as good as could have been. There are a lot of flat-earthers out there sadly
Woodstock and all:
Have read the upsetting posts above, the details on News and two or three other hot threads and, let me tell the world, I AM DEDICATED TO PREPARING as well as my circumstances permit!
Peak oil, global warming, asteroid threats, AIDS and even antibiotic resistant tuberculosis have not the immediacy of a Panflu51! Developments look so much worse today than a week ago, it’s amazing.
I browsed back on earlier threads, from last October on, a while back. How the worst expectations of that time have far more than come to pass now! Bird flu was ONLY in Asia, for example. No even suspected cases of H2H, no clusters! It looked like antivirals, once produced, would solve everything.
Hi Epi In Calif,
It seems that the stockpile in Australia stated as “enough for 1 million frontline responders for 8 weeks”, has been reallocated to those that become ill. While that certainly makes sense, our government is also saying that only 44,000 will die. Not sure if that includes being treated with Tamiflu or not. The main concern is that if the message is that there will be no prophylactic treatment for first responders, then it will be brave souls indeed that are face to face with infected people. I hope their masks are adequate! From what I hear there are not provisions for respirators in large numbers being provided for. So emergency nurses are supposed to wear …..what exactly? And ambulance/paramedics, local fever clinic personnel,etc. how are they being prepared? There are alot of questions in my mind, I just hope planners are asking them too, and then getting answers. Answers have been a bit scarce in Australia, it seems.
Hi Nikolai. I can relate to your experience with friends who “don’t get it” re panflu. And the AIDS pandemic is truly horrifying in the death toll, so on-going work, and more, needs to be done. But H5N1 panflu could kill as many people in a VERY short time as AIDS has killed in the past 20 years. The impacts of that on society are far worse due to the sudden impact and potential loss of societal mechanisms, like food distribution, policing, breakdown of healthcare systems, chronic shortages of pharaceuticals etc, etc.
The issue is risk perception by the public. It seems the threat risk is perceived as low and not immediate enough to warrant action. As we know ,however, by the time panflu has gone H2H, it will be too late to prepare much if it is highly transmissable and virulent. So education is a MUST. PREPARATION PREVENTS PANIC
dr kokosh 4 June at 03:33
Suggest you look at the MoH site for NZ Govenrment prepping, including media campaign. Positive action, no suppressing. Media just doing their usual thing and publishing what they think will sell more copies. http://www.moh.govt.nz/moh.nsf/indexmh/pandemicinfluenza-updates
Thanks kev yes NZ does have a nice little site which advises people to stock extra medicine and enough food for seven days. and yes i have seen the ads come on a few times to say wash your hands. but what really worries me is the false sense of security the NZ govt has put the population under by emphasising how we are one of the best prepared countrys in the world When in reality they need to state the truth and stop treating the population like protected children - for example maybe they could start by admitting that the 800,000 doses of tamiflu won’t be enough for 24% of the population and that the real dose (info available pointing to this for a long time now)will be more like twice the dose for twice the time. That while they had the money/expertise they chose to buy only one antiviral - the one with known structural predisposition to resistance. That they should have heard a loud bell ringing when France/germany jumped in and tied up the whole of 2006 production of relenza -or when Irland chose relenza for a large part of it’s stockpile - Maybe they should be telling the pop that it may be a good time to get a pneumoccocal vac -even if they have to pay $70 for it them selves -now would be a good time because there is no panic. Maybe thay should have informed the public when CSL’s failed vaccine trial resulted in the the CSL boss stating that it may now take 12mths instead of 6 to produce enough vac for the Aust pop and why there is one more country to vac before the NZ pop gets their order from CSL - or why indeed are we not setting up our own vac production facility-we have the expertise. why with no vaccine in site for at least 6mths and not enough anti virals to do any good are they suggesting a seven day supply of food. Why not tell the truth - if none of the above changes your only garantee of survival is isolation till a vaccine arrives. When the h2h in indonesia went public with who the only thing i saw about it was a small section in the business news of the NZ herald and the state owned TV NZ didn’t even mention it.NZ has been lulled into a near comatose state by the govt re bird flu and while it’s not good to promote panic it would certainly be nice to see some active public debate re the real state of our national preparations.Maybe they could even take the bold step of approaching Biota holding the Australian co which is in advanced human trials with the first 2nd generation neuradimase inhibtor (super relenza) LANI and get to the top of the list - just in case it does turn out to be the cheapest most effective way to bulk store an advanced pandemic anti viral as it is tipped to be.
Granted, we cannot KNOW the H5N1 pandemic is indeed coming, but continuing indications do not reassure us it is going away either.
The following is copied from ‘News Report June 5′ post by MaMa. It emerged on the official organ of the Chinese Communist Party, so the usual automatic debunkers are warned in advance to just scroll on past.
People’s Daily online- “The Chinese government should review the strategies and effects of the bird flu control efforts of the past two years and improve them to cope with the epidemic which is still a serious threat, said a Chinese scientist in Beijing on Monday.
“When, and to what extent, the current avian influenza virus could evolve into a human pandemic is unpredictable. We should do our best to reduce the risk of a human pandemic influenza breaking out and make necessary preparations before such a risk becomes reality,” said Chinese bird flu control expert Liu Xiufan…”
…”Some changes in the H5N1 virus have taken place recently. The virus has increased virulence to ducks, and the currently available vaccines are not effective for protecting poultry, said Liu.
The H5N1 viruses isolated during the 2004–2006 period have increased their ability to replicate in mammalian cell culture. The transmission mode of the viruses is changing from fecal-oral to aerosol, said the scientist, adding that the viruses have increased resistance to the environment, especially to temperature.”
I take the pandemic threat implications of the final two paragraphs very seriously.
It is even possible the Chinese know more than we here do.
Nikolai-Sydney: IT does seem to have us “by the throat” doesn’ t it? (By the way, good to have you back).
dr Kockosh — 17:19 wrote:
“Maybe thay should have informed the public when CSL’s failed vaccine trial resulted in the the CSL boss stating that it may now take 12mths instead of 6 to produce enough vac for the Aust pop and why there is one more country to vac before the NZ pop gets their order from CSL - or why indeed are we not setting up our own vac production facility-we have the expertise. why with no vaccine in site for at least 6mths and not enough anti virals to do any good are they suggesting a seven day supply of food. Why not tell the truth - if none of the above changes your only garantee of survival is isolation till a vaccine arrives.”
I am absolutely stunned at the news in your post! Shocking! I never dreamt but that NZ was the shining light of prepping! Frankly, the NZ situation scares the hell out of me here in Sydney. And raises more questions as to our situation here.
yeh it makes me bristle every time i hear how well we are doing Nikolai
my ex works in an essential govt industry in NZ…and *I* had to educate her about BF. The info the govt had given employees was so watered down as to be a joke
First piece of govt info I’ve seen today - a circular to all state govt departments requiring copies of emergency/disaster plans to be filed in case of any “emergency situation including avian influenza”. So it sounds like they are taking it more seriously than I thought.
I guess I’ll be spending the next few weeks on telework planning…
Aziraphale — 07:25 posted this
“First piece of govt info I’ve seen - a circular to all state govt departments requiring copies of emergency/disaster plans to be filed in case of any “emergency situation including avian influenza”. So it sounds like they are taking it more seriously than I thought.”
Yes, it makes me optimistic, things will get done, antivirals will be produced in quantities, plans will be perfected and the general public will stock adequate food and water while the effective vaccines are stored for use.
All we need is another ten years grace. Except that then the whole threat would be thoroughly discredited as non-existent and nothing in the above paragraph would have been done!
I like that succinct American turn of phrase: “We’re screwed.”
Bumped to encourage regulars, (e.g. Woodstock and Aussie One) to say hello!
Good morning all!
I think its time to move to 18. Perhaps Annie could do another of her fabulous summaries?
Old thread - Closed
We’re up to around 20 now…